This application proposes to use a multi-center approach to: 1) compare adults with Type I diabetes who did and did not have a recent history of severe hypoglycemia (SH) on biological, psychological and behavioral parameters, 2) use these findings to identify mediating variables that prospectively predict who would and would not have future SH; 3) based on these findings and our bio-psycho-behavioral model of SH risk, develop a Hypoglycemia Anticipation, Awareness and Treatment Training (HAATT) intervention to prevent SH in high-risk patients; 4) use a 2 (HAATT vs. Control) x 2 (pre-post treatment) design to evaluate HAATT's short term efficacy in terms of mediating variables for SH and, 5) in the fifth year complete a 12-month follow up to assess HAATT's long term efficacy and primary impact on reducing the low frequency events of SH and its negative sequelae, such as motor vehicle violations. Despite our study-section approved budget being cut by 58 percent, and our time frame reduced from five to four years, we accomplished all of the above except the fifth year long term follow up, which is crucial for both the evaluation of HAATT and the development of our future research plans. We are proposing a one-year grant to complete this critical long term follow up study of HAATT, to analyze and write up our findings on the short term effects of HAATT and to formulate our long term research plans.